Individual
ANNA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 N FRANKLIN ST, FORT BRAGG, CA 95437-3602
(707) 961-0172
Mailing address
PO BOX 2168, FORT BRAGG, CA 95437-2168
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/19/2014
Last updated
07/12/2016
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